Formative Feedback Form

Formative Feedback Form - MID SEMESTER FORMATIVE FEEDBACK...

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MID SEMESTER – FORMATIVE FEEDBACK FOR EPC I Student ___________________________________ Evaluators ___________________________________ Date____________________________________ Circle the box which best describes this student's typical performance of indicated competencies. 1. Professionalism: Needs Remediation Acceptable Good to Very Good Exemplary Tendency to put self-interest above that of patients and peers. Has some difficulty recognizing limitations, tendency towards arrogance. Sometimes has difficulty accepting constructive feedback. Disrespectful to any member of small group, Harrell Center Staff and/or patients. Does not consistently strive for excellence, sometimes cuts corners. Missed small group, lectures, and Harrell Center sessions or is frequently late. Fails to dress professionally. Never brings Bates textbook or appropriate medical instruments. Does not review videos prior to small group. Does not turn in assignments. Usually recognizes limitations in knowledge/skills and asks for help. Accepts feedback well but may not actively seek it. Rarely participates in small group. Generally strives for excellence but may need to raise standards. Attended some small group, lectures, and Harrell Center sessions. Usually dresses professionally. Sometimes brings Bates textbook and appropriate medical instruments Usually reviews videos prior to small group. Most assignments turned in on time. Good ability at self-assessment. Actively seeks feedback. Makes an active effort to treat everyone with respect and courtesy. Usually participates in small group. Strives for excellence. Attended most small group, lectures, and Harrell Center sessions. Dresses professionally. Always brings appropriate medical instruments and Bates textbook. Always reviews videos prior to small group. All assignments turned in on time. Insightful in identifying strengths and weaknesses and actively seeks feedback. Professional demeanor (respect,
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Formative Feedback Form - MID SEMESTER FORMATIVE FEEDBACK...

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